Pharm Week 3

heparin

indirect thrombin inhibitor - rapid onset

prevention of DVT and pulmonary embolism

preg safe, monitor PTT

AE: thrombocytopenia, osteoporosis

enoxaparin

low molecular weight heparin

Lovenox

injectable blood thinner for blood clots like DVT or PE

can be used at home, no monitoring required

fondaparinux

indirect factor Xa inhibitor

not reversible by protamine sulfate

warfarin

vitamin K antagonist

slow acting, pregnancy class X, avoid grapefruit

monitor INR

reversal: vitamin K (helps produce clotting factors)

prevent clots for indicators that cause thromboembolism

AE: bleeding, rash, skin neurosis, necrosis, alopecia

apixaban

direct factor Xa inhibitor

prophylaxis of DVT after surgery

stroke prophylaxis in patients with a fib

no monitoring required, don’t use with artificial heart valves

AE: general bleeding risk

dabigatran

direct thrombin inhibitor

do not use with artificial heart valves

alteplase

fibrinolytics - clot buster

convert plasminogen to plasmin, degrade fibrin clots

reversal agent: aminocaproic acid

aspirin

antiplatelet - inhibit platelet aggregation

A2 inhibitor

clopidogrel

antiplatelet - inhibit platelet aggregation

used in stent replacements to prevent blockage of stent

loratidine

antihistamine

2nd gen allergies

ceterizine

antihistamine

2nd gen allergies

promethazine

antihistamine

1st gen nausea and vomiting

AE: sedation and anticholinergic (dry)

diphenenhydramine

antihistamine

1st gen benadryl and allergies

AE: sedation and anticholinergic (dry)

SABA

albuterol - asthma emergency

AE: b receptor stim, fight

LABA

salmeterol

formoterol

long term control and prevention

AE: b receptor stim, fight

LAMA

tiotropium

COPD and asthma

inhaled corticosteroids - dec inflammation and eosinophil activity

budesonide - asthma and COPD

fluticasone - long term control and prevention

LTRA

montelukast

AE: depression and suicide

monoclonal antibodies

omalizumab

lower IgE

methylxanthine bronchodilator

theophylline

narrow therapeutic range

avoid caffeine

HMG-CoA reductase inhibitors

atorvastatin

rosuvastatin

simvastatin

first line for elevated LDL’s

take at night

AE: rhabdomyolysis, neuropathy, joint pain, hyperglycemia

CI: macrolides, fibrates

Bile acid binding resins

cholestyramine

colestipol

colesevelam

AE: dec absorption of fat soluble drugs, nausea, vomiting, diarrhea

CI: don’t take other drugs 1-2 hours before

cholesterol absorption inhibitor

Ezetimibe - block cholesterol absorption, often used with statins

AE: myopathy

CI: liver dysfunction, pregnancy

PCSK9 inhibitors

alirocumab

evolocumab

allows removal of LDL from the blood

AE: nasopharyngitis, itching, allergic rxn

nicotinic acid

niacin

inhibit lipase and reduce LDL and VLDL

AE: flushing, nausea, vomit, itch, hyperuricemia

fibrates

fenofibrate

gemofibrozil

reduce triglycerides and VLDL

AE: nausea, vomiting, diarrhea

CI: statins, gallstones, pregnancy